Immigration: Legal and Illegal - Research Paper Example

? Immigration: Legal and Illegal The United s has been known as ‘nation of immigrants’. Indeed, since 1820 the country has accepted almost twice as many migrants and refugees as other countries altogether. Overall, the number of people who come legally has varied depending on a historical period, changes in the legislation, and economic growth rates. Today, legal plus illegal immigration to the United States make up nearly 36% of its yearly population growth (Miller & Spoolman, 2011). A “nation of nations”, the U.S. differs from other nations of the world in the degree and scope to which the country has absorbed representatives of other nations. The Unites States has a population which consists of ethnic representatives of more than 170 countries (Hanson, 2007). This paper discusses immigration and how it affects the U.S. population. It focuses on legal and illegal immigration to the United States and assesses its significance in terms of impact on the American population. Next, the paper looks into the impact of immigration on the U.S. healthcare and explains why immigration has been a matter of concern for the American public. Finally, the paper discusses the role of the Community Health Nurse in solving this issue. It concludes with implications for Community Health Nurse’s practice currently and in the future. Immigration: Legal and Illegal By recent estimates, the United States has welcomed around $70 million immigrants who came legally; the number of illegal immigrants reached the number of $11 million (Le May, 2007, p.xv). Between 1820 and 1960, the majority of legal immigrants who came to the country arrived from Europe. Since 1960, the majority have come from the countries of Latin America (53%), Asia (25%), and Europe (14%). Back in 2009, legal immigrants of Hispanic origin (two out of three – Mexicans) were found to make up 15% of the overall population; by 2050, they will make up one third of the U.S. population (Hanson, 2007). For immigration statistics, see Table 1. The effects of legal and illegal immigration on the U.S. society have been numerous. Changes in demographic situation have led to considerable changes in the economy. Whether legal or illegal, immigration has been found to make positive contributions to the economy of the United States. It has been estimated that immigrants bring $11 billion every year to the economy of the United States. On the other hand, there have been losses with regards to amount of taxes paid vs amount of received social services. Besides, immigrants often act as competitors in the job market, especially for low-paying jobs. The situation is quite controversial here: while the general public believe that immigrants take their jobs and deprive them of good working places, scholarly research provides data that the jobs taken up by immigrants are typically manual, the ones that U.S. citizens are unlikely to do. Another positive impact of immigration is maintenance of relatively high fertility rates in comparison with Europe or Japan (Lust, 2012). Table 1: Inflow of legal Immigrants: Major sending countries, 2010. Country 2010 Region 2010 Mexico 139,120 Americas 423,784 China 70,863 Asia 422,058 India 69,162 Africa 101,351 Philippines 58,173 Europe 88,730 (Adapted from Migration Policy Institute, 2007). Another sphere influenced by immigration is healthcare. It is generally believed that immigrants tend to rely on unpaid public healthcare a lot. This question has been disputed though. For example, Simon (1995) found that immigrants contribute more to the health system than they take from it. Still, many people are concerned about the rates of diseases such as TB, hepatitis, and chagas that immigrants bring with them. To illustrate, the number of TB-cases fixed among individuals born outside the States is nine times higher than the one among people born in the United States. In terms of criminal involvement, opinions differ. For instance, scholars have found that Hispanic males are nearly 4 times more likely to be imprisoned at some time in their lives than non-whites (Hispanic prisoners in the United States, n.d.). On the other hand, 2000 US Census data evidence that foreign-born individuals are less likely to engage in criminal activities (2006). Education has also undergone some changes in relation to increased immigration. For example, the number of Spanish-speaking students with relatively low level of English increased (Hook & Snyder, 2007). Respectively, white enrolment in public schools declined. As for universities, owing to increased immigration, the number of highly qualified professionals increased, namely those holding PhDs. Community Health Nursing and Immigration Undoubtedly, one of the biggest concerns in relation to immigration has been public healthcare. Refugees and undocumented (illegal) immigrants have minimal access to healthcare and medicines. The biggest affecting factor, as it has been established in the study by Hoefer et al (2006), is the immigration status. Specifically, individuals who come illegally have difficulty accessing healthcare. While fear of deportation is probably the biggest reason that prevents illegal immigrants from seeking medical care, language barriers are also important. Illegal immigrants face difficulties establishing relationships with family doctors, seek out care in case of emergency, and access different medications or doctor’s prescriptions (Hoefer et al, 2006). The results of this study provide some material for community-based nursing implications. Namely, it has been found that illegal immigrants tend to seek out medical help from community-based organizations rather than within conventional facilities. Therefore, it is the responsibility of a community nurse to provide necessary medical assistance to illegal workers requesting it. The findings of recent studies on health care provided to immigrants in the Unites States prove that immigrants (namely, insured immigrants) have considerably lower expenses than insured US citizens. On the one hand, this disproves a widely held public opinion that immigrants are a burden for the state since they take health care costs from US-born citizens (Ku, 2008). On the other hand, it evidences the need to take steps to bolster the quality of health care services provided to immigrants, for example, with reference to restoring access to Medicaid or providing the services of an interpreter (Ku, 2008; Okie, 2007). The study by Ku (2008) concludes that more efforts should be made to eradicate the disparities between health care provision for insured immigrants and US citizens. Specifically, Ku addresses the need to improve the quality of health care delivered to Asians, Hispanics, and other individuals that are foreign-born. In this context, the role of a community nurse is to make every effort to enhance the quality of health care provided to immigrants and ensure that disparities do not affect health care services. Wessel’s article “Nurse practitioners in community health settings today” provides a good overview of the role of the community nurse and interventions that can be taken (Wessel, n.d.). Specifically, a community nurse may be involved in provision of primary care to uninsured immigrants. This is done on mobile vans, at school, at home, in clinics, shelters, and jails. The nurse may also take part in collaboration with the organizations and agencies that care for the disadvantaged, for instance, the Association of Clinicians for the Undeserved. The interventions include Pediatric Asthma Prevention Project, early Childhood Caries Prevention Project, etc. Community nurse practitioners are trained to work in a variety of settings which include primary care, management, education/teaching, and research. This means that the community nurse practitioner taken on multiple roles in the U.S. health system, especially in relation to those communities that are in need of this type of health care. Prospects for future include community nurse practitioners taking up roles of primary care providers, as well as arranging the so-called “Minute Clinics” or some other kind of outpatient rapid clinic sections in department stores where NPs may promptly treat a range of episodic diseases, for example conjunctivitis or urinary tract infections. In the age of baby-boomers, care for the elderly is becoming increasing important, so the community nurse’s role will be indispensable in provision of geriatric care. Importantly, community nursing professionals should go on taking part in various interventions. These basically include screening, surveillance, outreach, case-finding, coalition building, health teaching, social marketing, consultation, disease as well as health threat investigation, referral plus follow-up, enforcement and development of policy, and organizing the community, etc. These interventions are to take place within the following levels of society: community, systems, family or individual. As for the organizations which could be relied upon in conducting these interventions, one of them is ACU. This organization is a non-profit and trans-disciplinary organization that unites clinicians, health care advocates, and organizations who work to improve health of U.S. populations which are underserved. Within the policy of this organization is provision of trans-disciplinary and holistic care via a cooperative team of professionals in the field of health care (Wessel, n.d.). Conclusion In conclusion, immigrants’ health care needs serious improvement in terms of quality and accessibility in the United States. With millions of illegal workers who fear getting treatment in conventional institutions and who do not have sufficient proficiency in English, the community nurse role is to provide necessary primary care, geriatric care, and educational services. This is especially important if to view the issue through the lens of the future trends in this country. References Hanson, G. (2007) The economic logic of illegal immigration. Retrieved from http://irps.ucsd.edu/assets/022/8797.pdf. Hispanic prisoners in the United States (n.d.) Retrieved from http://www.sentencingproject.org/doc/publications/inc_hispanicprisoners.pdf. Hoefer, M., Rytina, N., and Campbell, C.(2006). Estimates of the unauthorized immigrant population residing in the United States: January 2005.” Population Estimates.” Department of Homeland Security Office of Immigration Statistics. http://www.dhs.gov/publications-0#2. Hook, J. & Snyder, J. (2007). Immigration, ethnicity, and the loss of white students from California public schools, 1990–2000. Population Research and Policy Review, 26 (3): 259-277. Lust, J. (2012) America’s baby bust. The Wall Street Journal. Retrieved from http://online.wsj.com/article/SB10001424127887323375204578270053387770718.html. Ku, L. (2009) Health insurance coverage and medical expenditures of immigrants and native-born citizens in the United States. Am J Public Health, July 99(7), 1322– 1328. LeMay, M. (2007) Illegal immigration: A reference handbook. ABC-CLIO. Miller, T. & Spoolman, S. (2011) Living in the environment. Cengage Learning. Migration Information Source (2007) Debunking the myth of immigrant criminality: Imprisonment among first- and second-generation young men. Retrieved from http://www.migrationinformation.org/USfocus/display.cfm?ID=403. Okie, S. (2007) Immigrants and health care: At the intersection of two broken systems. N Engl J Med, 357(6), 525–529. Simon, J. (1995) Immigration: The demographic and economic facts. Washington, D.C. Wessel, L. (n.d.) Nurse practitioners in community health settings today. ACU. Retrieved from http://clinicians.org/images/upload/wessel_nurse_practitioners.pdf. Read More